Evaluation of Nicotine Dependence and Attitude toward Tobacco Habit and Quitting among Patients Attending Tertiary Healthcare Hospital: A Mixed Method Study.

Introduction: Tobacco consumption is a leading risk factor for numerous chronic conditions, including various cancers, pulmonary diseases, cardiovascular disorders, and cerebrovascular events. The initiation and continuation of tobacco use are influenced by a complex interplay of psychological, social, and environmental determinants. Utilizing a mixed-methods research design facilitates comprehensive understanding by combining quantitative measurement of tobacco dependence with qualitative insights into users' attitudes and motivations. Aim: This study aimed to qualitatively explore the attitudes toward smoking and cessation among current tobacco users attending tertiary care hospitals. Methods: A mixed-methods study was conducted among patients visiting a tertiary healthcare facility. Participants were recruited through purposive sampling. Tobacco dependence was assessed quantitatively using the Fagerström Test for Nicotine Dependence, adapted appropriately for both smoked and smokeless tobacco (SLT) products. Qualitative data were gathered through structured, face-to-face interviews focusing on themes related to tobacco use and quitting behaviors. Results: The majority of participants belonged to the lower-middle socioeconomic class (37.9%), and approximately one-third (31.4%) exhibited high nicotine dependence. The main factors implicated in smoking initiation were occupational workload and peer influence. Stress related to work was frequently reported as the primary reason for relapse following cessation attempts. Awareness of tobacco control policies and nicotine replacement therapy was notably low among participants from disadvantaged socioeconomic backgrounds. Furthermore, many expressed skepticism regarding the impact of government-imposed tobacco bans on reducing tobacco use. Conclusion: The findings indicate that individuals from low socioeconomic strata have higher levels of nicotine dependence, with SLT use surpassing smoked forms, likely due to the comparatively lower cost. This underscores the urgent need to implement targeted educational and cessation programs that address the health risks of tobacco consumption, particularly within socioeconomically disadvantaged populations. [ABSTRACT FROM AUTHOR]